First published 2001 in Quadrant magazine: Quadrant 376 (May 2001): 45-52.
This article is a response to Margaret Somerville's book The
Ethical Canary.

Professor Somerville published a detailed reply in the
July-August 2001 issue of Quadrant, and I then
responded further in the September issue. Those interested in our
different approaches to bioethics should, of course, consult the
original publications for the entire debate.

Margaret Somerville and the
Perils of Bioethics

by

Russell Blackford

In an obvious sense, deep thinking is required to tackle
ethical issues related to the use of biomedical technology. This
is clear enough whether the issues are familiar, such as the
rights and wrongs of abortion and euthanasia, or those of more
recent notoriety, related to new or merely postulated
technologies that require the manipulation of genetic material.
Of course, the newer issues are complex in additional ways:
technologies such as cloning for reproductive or therapeutic
purposes are often poorly understood; they are difficult and
strange in their underlying theory, in their actual or imagined
operation and effects, and in their possible consequences.

All of these issues, old and new, demand careful, open-minded
thought. They need to be considered patiently,
analytically"in-depth".

Moreover, arguments in the field of bioethics may ultimately
compel us to identify and examine our own deeply-held intuitions,
as commonly happens in other areas of philosophy. Philosophers
typically ask questions that cannot be answered by deduction from
self-evident premises, or from premises that are open to
practical verification or experimental tests. When dealing with
normative ethical issues, philosophers frequently dig down
through the strata of argument and counter-argument to uncover
premises that are not susceptible of any further support but
simply appear plausible as moral intuitions, reflecting
individuals' fundamental principles or commitments. Then the
question is whether these intuitions remain so attractive after
their meanings and implications are scrutinised in detail and an
attempt is made to fit them into the general matrix of human
experience.

In these senses, it is the job of philosophers, particularly
ethical philosophers and certainly including bioethicists, to
think deeply about the issues they confront, and to look for
intuitions that are deeply, strongly, and perhaps widely, held.
Philosophical analysis is a form of rational inquiry, but it
deals with questions that are not open to precise mathematical
and empirical investigation, either not yet or not ever. Because
of their subject matter, there is a sense in which philosophical
arguments cannot be demonstratively compelling all the way down.
With questions of ethics or metaphysics, there is always the
prospect that equally rational opponents may end up identifying
disagreement at a very deep, essentially intuitive level.

While this may be an unpalatable recognition, it is very
different from the claim that philosophical questions can be
settled by drawing upon a well-spring of "deep",
non-rational knowledge that is available when the processes of
rational analysis and argument run to their end. Philosophers who
speak of "deep" or "profound" truths in this
latter sense may sound wise or noble, but they deserve our
suspicion, not our open-mouthed admiration.

Bioethical issues provoke more than their share of faux
"deep" thinking, and Margaret Somerville's recent
treatise, The Ethical Canary: Science, Society and the Human
Spirit (2000), is a case in point. At least when the author
is writing about philosophical issues, rather than more narrowly
legal ones, she gives the impression that an incessant repetition
of the words "deep", "profound" and their
cognates is intended to lend her own analysis an air of
profundity.

For example, she wants us to "pass on to future
generations a value of profound respect for the transmission of
human life". She has qualms about abortion because it
conflicts with her view that "the passing of human life to
the next generation deserves the deepest respect". When she
considers the mandatory destruction of embryos stored in liquid
nitrogen, she declares: "There is something grossly wrong
with our moral intuitions if a law that mandates mass
extermination of any form of human life does not raise the most
profound ethical concerns." She refers elsewhere to
"the profound sense of respect and responsibility that we
should feel for the immense powers the new science and
technologies have placed in our hands."

Despite her self-presentation as a rigorous
"ethicist", able to put the heedless, amoral
Frankenscientists in their place, Somerville relies on the
pervasive use of loaded words that are insufficient to support
her quasi-religious world view. She does not emerge as a good
philosopher, more the priestess of a new kind of superstition.

#

Margaret Somerville is an Australian medico-legal academic,
now living and teaching in Canada, where she is a professor at
McGill University in Montreal. The Ethical Canary is meant
to shed light on the whole field of contemporary bioethics, but
sometimes reads like a distillation of everything that is wrong
with it, particularly since Dolly was cloned in 1997 and
bioethical writing became a new province for moral panic.

Along with Somerville's appeal to supposedly deep spiritual
insight goes a plea for the advancement of biomedical science to
slow down, so that ethicists can catch up. Given this express
wish to put a brake on scientific progress, Somerville may quite
accurately be referred to as a "neo-Luddite", a tag
that has been applied to her by the Canadian press and which she
seems to wear with a mix of resentment, pride and defiance. She
puts a poor case that bioethical thinkers must take longer to
apply their theories to some postulated technological marvel than
biomedical scientists take to do the work of actually delivering
it. The real problem is that she wishes to create a social
consensus on the rights and wrongs of bioethical issues. That,
however, is impossible and undesirable, since a healthy democracy
thrives on philosophical disagreement.

Bioethical thinking is not more difficult than actual science,
though both are intellectually difficult endeavours, nor
inherently more time-consuming. However, at least when they are
dealing with well-defined, non-politicised problems, working
scientists can often deliver an expert consensus that has
undeniable practical applications. By contrast, the outcomes of
philosophical thinking, in bioethics and elsewhere, are typically
inconclusive. That is the very nature of philosophy. This is not
a reason to slow down the advance of science, for, in current
circumstances, biomedical science could never move slowly enough
for an ethical consensus to form in its immediate wake. It is a
reason for bioethicists to display greater modesty when they draw
conclusions as to what is or is not ethically permissible. In
cases of doubt, and in the absence of serious fears about safety
or damage to the environment, freedom of choice and intellectual
inquiry should prevail.

I do not entirely rule out social prescriptions with a
neo-Luddite element. Some technologies may indeed be too risky,
in one sense or another, to develop or apply. Perhaps the burden
of proof is not entirely upon those such as Somerville or, in
another context, Bill Joy who wish to relinquish certain
technological possibilities. If the negative consequences are
highly probable and very great, we might do best to close off
certain lines of inquiry and innovation. Be that as it may, I
require the danger to be something tangible before I'll be
convinced in any particular case, something that is obviously a
safety concern for human societies or the human species, not some
subtle threat to the good of our souls. I'll look after my own
soul, thank you very much.

Somerville's brand of neo-Luddism is most impressive when she
expresses doubts about xenotransplantation: the medical
transplantation of organs from genetically modified animals. She
develops a plausible case for hesitation and care in developing
and using this technology. However, along with the dense texture
and plausibility of the argument at this point, goes a potential
vulnerability to technical rebuttal. I am not confident one way
or the other whether the safety concerns that she raises about
xenotransplantation are legitimate, but I do not expect her to
prove them beyond any rational possibility of doubt before I take
them seriously. There is room for some precautionary thinking
here, however much the merits of the so-called
"precautionary principle" have been distorted and
exaggerated by pop environmentalists.

However, Somerville's arguments more typically depend upon
"profound", metaphysical assertions about our
obligation to revere life, and even death. These are not open to
empirical confirmation or rebuttal. I now turn to those
arguments.

#

Somerville's starting point is that we are ethically obliged
to accept and act upon two absolute values, which she suggests
are "probably two sides of the same coin". These are
(1) "we must always act to ensure profound respect for life,
in particular human life" and (2) "we must protect and
promote the human spirit".

She defines the "human spirit", somewhat
confusingly, as "the intangible, invisible, immeasurable
reality that we need to find meaning in life and to make life
worth living" and as "that deeply intuitive sense of
relatedness or connectedness to the world and the universe in
which we live". Later, she refers to "the essential,
intangible, invisible, immeasurable reality we need to live fully
human lives, that 'non-physical entity' through which we find a
sense of meaning in our lives". It is not obvious to me that
these are entirely interchangeable formulations, but that may not
matter, since the cloudy idea of the "human spirit" has
little independent role to play in her thinking. Her arguments
are structured around the imperative of "profound respect
for life", which she elaborates in various ways to reach
such conclusions as that euthanasia is inherently wrong, as is
human cloning for any purposethough not abortion, at least
not in all cases. Despite the book's sub-title, Science,
Society and the Human Spirit, the human spirit enters into
the picture only when the author wishes to assert that the human
reproductive cycle is what gives life meaning.

At certain points, Somerville attempts to modify, or colour,
our understanding of a word or idea by references to etymology.
For example, she informs us that "religion" "comes
from re-ligareto bind together". More
importantly, she provides an etymological discussion of
"respect", a word which is pivotal to the book's
argument. She tells us that it "comes from the Latin word to
look back on" and that "Respect is the mechanism
through which we remember, and it requires us to see ourselves in
a larger context than just ourselves."

This understanding of respect is worth reflection. Although
Somerville does not put it in quite this way, it is arguable that
to respect X, taken at its broadest, is to perceive X as a
providing a constraint on our own spontaneity and self-interest.
We must take it into account before we act unthinkingly, or as we
think best for ourselves. This idea coincides with one definition
of "respect" in The Macquarie Dictionary:
"consideration or regard, as to something that might
influence a choice". The idea is present if I state that I
respect the power of the stormI will not go driving in it,
much less put out to sea, but will stay at home in relative
safety.

In other contexts, X's influence on my choice might be moral
rather than prudential, and it is this idea of respect as the
perception of a moral constraint that I have in mind in the
following paragraphs. There are other senses of the word
"respect" in which we do not respect every human being
whom we encounter, or read or hear about. Some individuals do not
seem to deserve our esteem or deference, certainly not our
reverence. But we do treat our fellowsall of themas
morally constraining our ability to act without thought, or
wholly in our own interests. We must give their separate
interests at least some regard.

When asked how other humans can impose this kind of constraint
upon us, we may say that it arises from the fact that they
possess certain attributes which we cannot ignore. In the case of
other adults, these include sentience, self-consciousness,
rationality, moral agency, autonomy, the ability to formulate
life plans, deep inner experience, and the burden of mortality
that they share with us (I owe this composite list to thinkers as
various as Bertrand Russell, Robert Nozick, Peter Singer and
Raimond Gaita).

Babies and children, it is true, do not possess all of these
attributes, but they possess others that may compel us to have
regard to their interests, making them seem uniquely compelling
subjects for our care and kindness. Not least important are their
developing human minds and personalities, and their social
dependence if they are to grow and flourish. We are not absolute
slaves to the interests of any child in our vicinity, but the
welfare of a child is always something we must take into account
when our actions, or inactions, touch upon it.

Non-human animals possess few of the attributes I have
mentioned, but they do possess sentience, to varying degrees, and
some appear capable of suffering in ways that include, yet go
beyond, physical pain. These attributes of animals may be enough
to create moral limits on how we can treat them. If we think
about this seriously, we may feel compelled to become a
vegetarians, though it is not clear that this is morally required
of an historically omnivorous species such as ours. Perhaps an
appropriate response is to kill with the minimum of cruelty, use
as much of the animal's carcass as possible to minimise waste and
slaughter, perhaps enjoy our meat with a sense of thankfulness
tinged with regret. At the least, we may owe it to some animals
to ensure that they are not subjected to extreme pain or to lives
of suffering.

What about non-sentient things? Even these may constrain our
actions morally, either because they have intrinsic value or
because they have derivative valueharming them may harm
other human beings or other sentient animals. Some forests and
gardens may have sentimental, aesthetic or utilitarian value
which requires that we treat them in particular ways. Certain
individual trees that are famous throughout the world, such as
the General Grant redwood in the US and the magnificent Tule Tree
in Mexico, seem to possess extraordinary value, though there is
room for argument as to whether this is intrinsic or derivative.
To destroy or harm them would seem acts of reprehensible
vandalism. The same can apply to works of art, as evidenced by
the widespread sadness and condemnation provoked by the Taliban's
destruction of the Buddha statues which it characterised as
idols, or to certain landscapes and seascapes. It is meaningful
to say that all these should be treated with respect: they
cannot, morally, be treated however you or I like.

At the same time as I was pondering The Ethical Canary,
I also read Rosaleen Love's delightful Reefscape: reflections
on the Great Barrier Reef, which also expresses a sense of
the connectedness of biological nature, including humankind.
However, despite sharing with Somerville a penchant for that
clichéd and irritating phrase "other ways of knowing",
Love resists the attractions of worshipful
"spirituality" and puts a level-headed, convincing plea
for the Reef's remarkable beauty and unexpected fragility. Her
words must surely resonate with anyone who has ever lived in or
visited north Queensland. If I needed convincing, I am entirely
convinced that the Reef's "intricacy and beauty" impose
a moral constraint on our actions. We cannot just treat the Reef
however we like, but must have regard for it, respect it. It is
not exactly a matter of respecting its "interests" but,
at one extreme, it would be morally wrong to destroy such a thing
spitefully or on a whim.

What is interesting about this spread of cases is that the
kinds of respect we show to a human adult (whom we may or may not
hold in high esteem), a child, a baby, a non-human life form,
some other natural phenomenon, or a cultural artifact involve
quite varying moral obligations. It is not sufficient to state
that "X should be treated with respect" for somebody to
read off precisely how we should conduct ourselves in regard to
X.

In the case of another human adult, I may sometimes feel
constrained to accept decisions that strike me as foolish and
self-destructive; that, of course, is the problem about
paternalism. While I have an obligation to pay regard to the
welfare of another adult with whom I interact, I must also
respect her wishes, even if these clash with my perception of her
welfare. She may want to take a course of action that I perceive
to be harmful, such as using dangerous drugs, lightly abandoning
a valuable friendship or a career with good prospects, or
frittering away her time and money gambling. While I may take
some actions, such as attempts at persuasion, in the hope that
she will not do these things, there are many situations where my
respect for her autonomy outweighs not only my perceptions about
my own interests but even my perceptions about where her best
interests lie.

With a young child, paternalism and autonomy are not such
issues: my overriding obligation is to avoid harming the child
and to protect and nurture her if she falls into my care, even
when this means thwarting her own desires and plans. However,
there are moral problems about the lengths I may go to in an
endeavour to mould her personality to suit my own convenience, or
my idiosyncratic beliefs and values. The case of non-human
animals is different again.

In a case such as the Great Barrier Reef, what is called for
is surely some kind of individual and collective care in
preserving the seascape and the wider environment that sustains
it. While that much is not controversial, it leaves room for
detailed debate about development, climatology, marine science
and similar matters. Nonetheless, if we agree that the Reef must
be respected in a particular way, that it constrains specific
aspects of what we can do unthinkingly or selfishly, we might
reach consensus on these more detailed and technical problems. In
any event, our goal is surely not to avoid hurt to the Reef's
feelings, for example, or to offer it our reverence by never
vacationing elsewhere.

It is salutary to be reminded from time to time that a fellow
human being, a suffering animal, a beautiful, fragile seascape
should be treated with respect. But this does not tell us just
what we are obliged to do or refrain from doing, exactly how the
person, animal or thing provides moral constraints on our
actions. To the extent that we can know what these constraints
are in a particular case, the knowledge comes from an
appreciation of the person or thing concerned and an
understanding, or intuitive sense, of its relevant attributes.
The word "respect", then, can sum up the existence of
moral constraints. It can also give a useful reminder to stop and
look beyond ourselves, but it does not, in itself, contain any
detailed normative content. We respect many and various things,
and behave towards them in equally various ways.

Somerville's etymological discussion suggests this
understanding of "respect", but it is noteworthy that
she usually speaks of "deep" or "profound"
respect, or else uses the word "reverence". Her claim,
once more, is that we must "ensure profound respect for
life, in particular human life", but what does this actually
mean? One wrong interpretation is that she intends to suggest
that life as a whole, or human life as a whole, provides a moral
constraint on our actions. This proposition is plausible, if not
especially illuminating. After all, without indulging in the New
Age excesses of Gaia worship, we can conceive of life on Earth as
a total ecological system with limits to its resilience. In
theory, some destructive acts could annihilate all life on our
planet. More plausibly, they could leave the cockroaches and
bacteria in charge, but render the Earth uninhabitable for human
beings. No doubt Somerville would obtain widespread agreement if
she merely reminded us of this and proposed that such disasters
be avoided at almost any cost.

This, however, is not what she means, showing that we must pay
attention to the intellectual content of ethical maxims rather
than succumbing to their cadences. The repetition of words such
as "profound" and "deep" is not merely the
symptom of a wish to sound wise and impressive. When these
adjectives are attached to the word "respect", as they
often are, they signal that Somerville is arguing from extremely
dubious premises. As The Ethical Canary proceeds, it
becomes clear that her logical starting point is that we should
regard human genetic material and the cycle of human reproduction
with respect in a different sense: a reverence that borders on
awe and worship. That imperative, however, is not entailed by
such a vague, innocuous proposition as "we should pay due
regard to the value of human life as a whole".

Somerville, then, does not deduce, but assumes, that we should
venerate every particle of human life, such as an individual
zygote or embryo, as well as the process of sexual reproduction
itself. These things are to be more or less worshipped in a new
quasi-religion, a "science-spirit" world view, as she
calls it, of Somerville's own construction, though her expression
of her intuitions is obviously that of a woman who was profoundly
affected by a Catholic religious upbringing, as she makes clear
in the book's "Epilogue" and
"Acknowledgments" sections.

To sum up at this point, good sense can be given to the idea
that we must respect other people, some other animals, and even
some non-sentient things, which means recognising that they
constitute moral limits upon our behaviour. Some vague sense can
even be made of the idea that we should respect life, or human
life, as a whole. Somerville, however, wants to argue from
premises far stronger than this, so strong as to be almost
question-begging. Her conclusions depend on a quasi-religious
attitude of reverence for human genetic material and the cycle of
human reproduction. Yet, this is highly dubious as a starting
point in controversy about bioethical issues. Many people
will reject such an underlying view once it is stated clearly.

Somerville is entitled to hold and express her science-spirit
view if it reflects her deepest intuitions about these matters.
However, it provides an unacceptable basis for public policy
decisions.

#

Somerville is opposed to the use of human cloning techniques,
whether as a method of reproduction or for the creation of cells
or organs for therapeutic purposes. She discusses safety concerns
about the nuclear somatic transfer technique used to create
Dolly, and other concerns about the possible psychological and
social consequences if reproductive cloning were attempted
successfully. All these matters require careful consideration,
but Somerville inevitably considers both reproductive and
therapeutic cloning to be "inherently wrong" in any
event. Her essential argument, as far as I can identify and
reconstruct this, is that any form of human cloning is
inconsistent with reverence for the natural cycle of human sexual
reproduction, which she sees as intricately tied to the meaning
of life. The following passage is representative of her tone and
ideas, while summing up her position on human cloning:

There must be a reverence for the creative forces
of nature in the passing on of human life and we
need to inquire what limits this requirement
would place on us using our genetic science.
Human reproductive cloningand human
therapeutic cloningcontravene the most
fundamental requirements of reverence in the
passing on of human life.

As for the meaning of life, and with it the human spirit,
Somerville makes the connection in these terms:

The sexual transmission of human life is integral
to our sense, as both individuals and a society,
of ourselves and of the meaning of human life.
Can we afford asexual transmission, no matter
what benefits it promises? Human life is not a
commodity. Can we ever afford to make it such?

There may be legitimate arguments that it ethically
impermissible to commodify our reproductive capacities or human
genetic material, in the sense of selling them for profit. In
Somerville's treatment, however, any such concerns are merely
derivative of her main idea, which is that we are morally obliged
to respond to these things with quasi-religious awe and worship.
It is significant that she sees the argument as applying to
therapeutic cloning, where no fully-formed human being ever comes
into existence, as much as to reproductive cloningand this
is cause for special concern. Though human reproductive cloning
should be discouraged while safety problems remain, the use of
cloned embryos for the development of biomedical science's
therapeutic capabilities is an altogether different issue. It is
alarming to realise that the development of powerful new
therapeutic techniques may be retarded by policies based upon a
highly dubious, quasi-religious world view.

When it is reconstructed and explained like this, Somerville's
account clearly cannot resolve bioethical disagreements about
issues such as human cloning because her premises are as
intellectually unpersuasive as her conclusions. To put the
problem another way, Somerville's approach to solving bioethical
problems is surprisingly shallow. She reasons from premises that
are too close to the surface of the argument, too much like the
conclusions that she wishes to draw. Her intuitive stopping point
is one where she is already embroiled in metaphysical and moral
controversy with almost any conceivable opponent.

Her basic analysis is no better when she approaches well-worn
issues of controversy such as euthanasia. Admittedly, her
subsidiary arguments, grounded in a well-informed understanding
of medical practice, are sometimes quite persuasive. For example,
she convincingly describes how modern pain-management is more
effective than is generally known or acknowledged by advocates of
voluntary euthanasiathis might, indeed, be a practical
reason to discourage euthanasia and encourage palliative care.
However, the main line of her argument is about reverence for
life and death. If this succeeds at all, it proves that no one
can ever be given a lethal injectionor any other quick,
merciful deathno matter how terrible and unavoidable their
suffering, and whatever their own wishes, without the commission
of a serious moral wrong. That conclusion is both unjustified and
cruel.

She argues that, if human beings have dignity simply from
existing, then euthanasia contravenes our inherent dignity. That,
however, is moving far too quickly to be plausible. Abstract
statements about human dignity are vague, and it is not clear
that any detailed moral content can be deduced from them alone. A
better approach is to reflect lucidly on the actual attributes of
human beings, including our autonomy, inner experience and
capacity for pain and suffering, then ask how we are to treat a
fellow human being who is in terrible pain that cannot be
alleviated and who wishes to die as soon as possible. We may well
respect her in an appropriate way, and at the same time treat her
with dignity, if we take the regretful step of giving her the
quick death that she wants. How can we be denying her dignity if
we pay attention to her particular situation, honour her wishes,
and respond with compassion to her terrible inner experience?
Words such as "dignity" and "respect" are
hollow unless they remind us to regard the particular other whose
plight confronts us.

When writing about euthanasia, Somerville appears unable to
treat her opponents fairly. In particular, she cites a science
fiction novel by P.D. James, about killing old people who do not
want to die: "One old woman tries to escape but is beaten by
a guard." Yet this is not euthanasia as commonly understood,
painlessly killing someone who is in terminal agony and wants to
die. It is unequivocal murder. Somerville writes, "Although
this is an extreme example and those who support the legalization
of euthanasia are likely to criticize my use of it, it does carry
an important message." Yes, I do criticize her: the use of
such a passage to appeal to our emotions by-passes the real
issues in a way that appears intellectually dishonest.

She concludes that we are obliged to "respect
death", since "if death has no meaning, life has no
meaning". Respect for death "requires each of us to
undertake the profound journey of life to its natural end",
which rules out euthanasia or suicide. Fundamentally, she
considers euthanasia wrong because it is a "failure to
respect death" and this supposedly contravenes her primary
imperative of "profound respect" for life. But this is
all psycho-babble.

Why should we respect death? Leaving aside Somerville's
frequent conflation of respect and reverence, there is an obvious
sense in which death is to be respected, analogous to the power
of a storm: the inevitability of death is something we must all
pay regard to. Each of us will die. That, however, is more a
prudential than a moral consideration. If it has any moral
significance, it may be that it reminds us to be kind to loved
ones who will not be with us forever, to avoid leaving our
dependents destitute should death befall us prematurely, and so
on. It has nothing to do with the ethical permissibility of
euthanasia.

However, is there any sense in which we are obliged to pay
regard to something analogous to death's "interests"?
It is not obvious how such an abstraction, death, could possess
even the kind of quasi-interests that might be imputed to a
seascape, an art work or a planet's biosphere. Accordingly, it is
unclear how death could provide a moral constraint on our actions
analogous to those provided by other human beings, other living
things, and things of artfulness or beauty. Death, after all, is
not the kind of thing that can be harmed, damaged or coerced. It
can be revered or worshipped, perhaps, but not respected in the
sense I have discussed in this article.

A possible reply is that a universe in which death was
abolished would become a hell of stagnation and tedium, and this
is a reason to respect the abstraction, "Death". We
should, it might then be argued, not seek true immortality (as
opposed, say, to a long, healthy life). Even if this rather
far-fetched argument were convincing, however, it would not
provide a reason why we should respond to our understanding of
death's benign aspect by never hastening anyone's death. Again,
it is unclear that a failure to pay due regard to the claims of
death entails that we have also failed to pay due regard to those
of life.

However, as I have discussed, Somerville does not attempt to
identify relevant attributes of life that oblige a regard for it,
much less identify what such a regard might consist in. Instead,
her emphasis is upon reverence for the process of sex and
reproduction and for human genetic material. If life is viewed,
somewhat reductively, as a reproductive cycle, death can be
treated as part of that cycle, in which case it might be asserted
with some plausibility that the entire cycle should be regarded
with quasi-religious awe and worship. If that is so, perhaps
tampering with death, in the sense of hastening it, can be viewed
as an irreverent act.

Yet, once we set out on this moonlit road of superstition,
almost anything goes. Might we not express our reverence for
death by ritually killing those whom death has already claimed in
the sense that they are terminally ill? Fortunately, there is no
reason at all for us to be converted to Somerville's
quasi-religion of life-and-death worship, and it should be given
no serious credence in policy debates over issues such as
euthanasia.

#

The Ethical Canary is not a worthless piece of writing.
It provokes thoughts about the nature of respect and dignity.
Moreover, its second half is largely an orthodox discussion of
medical law and policy, dealing with such issues as requisite
standards of consent to medical treatment and the problems of
allocating health resources efficiently and ethically.
Somerville's exposition of legal and policy issues is scholarly,
reasonable and genuinely impressive. The tone and language are
clear and persuasive. These chapters display less insistence that
the subject matter is "deep" or "profound",
though the author does insist, when discussing the circumcision
of male infants, that we must have a "deep respect for
religious, cultural and traditional beliefs".

The discussion of circumcision is well worth reading, as are
many other areas of the book whenever its author relies primarily
upon her detailed medico-legal knowledge, rather than acting as a
missionary for her science-spirit world view. As in her
discussions of xenotransplantation and palliative care, she
appears well-informed about important matters of detail, enabling
her to put a persuasive case that circumcision is more traumatic,
and has less medical benefit, than is commonly realised. At the
same time, she is surely correct that some regard must be had to
religious beliefs associated with circumcision before we simply
prohibit it. She makes specific suggestions as to how the harm
that she says is done by the practice might be ameliorated. She
is also quite clear that the barbaric practice of female genital
mutilation is in an altogether more serious category of harm.

Somerville's legal and policy analyses, then, are most useful
when she writes essentially as a lawyer and on subjects that do
not seem to call for metaphysical solutions. In other areas, her
policy prescriptions are based on a world view that is personal
and metaphysical at bestat worst, bordering on
superstition. As her numerous citations indicate, she is not the
only bioethicist who is drawn to such an approach, but it is
neither intellectually persuasive nor an acceptable basis for
public policy in a liberal society.

We should be pause and think for ourselves before we defer to
the expertise claimed by professional bioethicists. This is a
field of growing relevance and importance, but it attracts many
people whose positions are fundamentally illiberal, if not
irrational. Their pronouncements merit scrutiny, criticism and
opposition.